The effectiveness of mailed patient reminders on mammography screening: a meta-analysis.
BACKGROUND
Researchers have tried to increase mammography screening rates by using patient-oriented reminders. This paper compares the effectiveness of mailed patient reminders at increasing mammography screening.


METHODS
Sixteen published articles met the inclusion criteria and were included in the meta-analysis. To assess the association between reminders and mammography screening, the Mantel-Haenszel odds ratio (OR) was calculated.


RESULTS
Among U.S. studies in which controls did not receive any type of reminder, women who received reminders were approximately 50% more likely to get a mammogram (OR 1.48; chi(2)MH(1) = 38.27, P < .001). In addition, tailored letters were found to be more effective than generic reminders (OR 1.87; chi(2)MH(1) = 4.70, P < .05). Combining cost and effectiveness data allowed for estimates of cost per woman screened, which ranged from $0.96 to $5.88.


CONCLUSIONS
Patient reminders are effective at increasing mammography screening. More research is needed to assess (1) the cost-effectiveness of patient reminders and (2) their effectiveness across race, education, income, and type of insurance.
Wagner
T H
TH
School of Public Health, University of California, Berkeley 94720-7360, USA.
D001943:Breast Neoplasms / Q000517:prevention & control*; D003365:Costs and Cost Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008327:Mammography / Q000191:economics / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000458:organization & administration* / Q000706:statistics & numerical data; D016017:Odds Ratio; D010349:Patient Compliance; D016730:Program Development / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D017010:Reminder Systems / Q000191:economics / Q000706:statistics & numerical data*; D012680:Sensitivity and Specificity; D014481:United States